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As national COVID inquiry wraps up, experts call for action on Centre for Disease Control, and air quality in schools

Introduction by Croakey: Leading health and medical organisations have urged the Federal Government to act swiftly in cementing the future of the Australian Centre for Disease Control (CDC), calling for funding to be announced by the end of the year and before the federal election is called.

The call – in a joint statement from the Public Health Association of Australia (PHAA), the Royal Australasian College of Physicians (RACP), the Australasian Society for Infectious Diseases (ASID) and the Climate and Health Alliance (CAHA) – comes as the COVID-19 Inquiry Response Report is due to be handed to the Government this Friday.

The Government has said the inquiry, initially due to report by the end of September, will help determine the CDC’s future structure and function. The statement also comes amid concerns about the implications of the retirement, effective 21 October, of the Interim CDC’s Head, Professor Paul Kelly.

Adjunct Professor Terry Slevin, CEO of the PHAA, said he is concerned about a lack of progress in setting up the CDC.

“During the 2022 federal election campaign, Prime Minister Anthony Albanese committed to establishing an Australian CDC in their first term of Government. This promise is yet to be fulfilled. Currently we have an Interim CDC, with funding that expires on June 30, 2025,” Slevin said in the statement.

“The COVID-19 Response Inquiry has been a very important and complex undertaking, and we fully support the Government’s decision to grant an extension to the Inquiry panel. However, as soon as the report is delivered, we expect to see the Government act very swiftly to fulfil its election promise before a Federal Election is called.”

Professor Joseph Doyle, President of the ASID, said Australia urgently needed a CDC with secure resources and clear governance, and that it needs to be “accountable to best protect Australians from new and emerging health threats including avian influenza and mpox”.

RACP President Professor Jennifer Martin said the CDC must also focus on chronic disease prevention. “The burden of preventable disease in our country is driven by modifiable factors such as tobacco use and vaping, unhealthy working and living environments, obesity and diabetes, underpinned by commercial determinants of health,” she said.

Michelle Isles, CEO of the Climate and Health Alliance, said climate change is increasing the burden of disease and disrupting our response to public health issues, and that the health sector and communities need certainty around the CDC’s future.

Slevin said Australia is the only country in the OECD without a Centre for Disease Control. “The Australian CDC could be the most important and impactful change in the Australian public health landscape in our lifetime,” he said. “It is critical it is set up effectively from the start with the right legislation and funding to deliver on its potential.”

Meanwhile, in an article also addressing the COVID inquiry’s imminent reporting, Adjunct Professor Geoff Hanmer, an architect, says that one of the lessons from COVID is the importance of improving air quality in Australian schools.

His article below was first published at The Conversation, with the headline, ‘It would cost billions, but pay for itself over time. The economic case for air conditioning every Australian school’.


Geoff Hanmer writes:

Later this week the Government will receive the report of the year-long independent inquiry into its handling of the COVID pandemic.

Among the issues it will have to contend with is air quality, in particular the air quality in high occupancy public buildings such as schools, aged care facilities, shops, pubs and clubs.

Many already have high quality air. High-filtration air conditioning (so-called mechanical ventilation) is standard in offices, hospitals and shopping centres.

But not in schools. Almost all of our schools (98 percent in NSW) use windows.

In Australia’s national construction code, this is called “natural ventilation” and it is allowed so long as the window, opening or door has a ventilating area of not less than five percent of the floor area, a requirement research suggests is insufficient.

Open and shut

There’s no requirement to actually open the windows. School windows are often shut to keep in the heat in (or to keep out the heat in summer).

The result can be very, very stuffy classrooms, far stuffier than we would tolerate in shopping centres. This matters for learning. Study after study has found that when air circulation gets low, people can’t concentrate well or learn well.

And they get sick. Diseases such as flu, COVID and respiratory syncytial virus (RSV) spread when viruses get recirculated instead of diluted with fresh air.

The costs of the resulting sickness are borne by students, parents, teachers and education systems that need to find replacement staff to cover for teachers who are sick and parents who need to look after sick children at home.

A pilot study prepared for the Australian Research Council Centre for Advanced Building Systems Against Airborne Infection (known as “Thrive”), suggests the entire cost of installing high-filtration air conditioning in every Australian school would be offset by the savings in reduced sickness.

The study carried out by the education architecture firm ARINA compared the ventilation of 60 so-called naturally ventilated schools in southern NSW and the Australian Capital Territory to that of a school in Sydney that happened to have been fitted with a Standards Australia-compliant air conditioning system to control aircraft noise.

It used carbon dioxide levels to measure ventilation. Carbon dioxide is a good proxy for ventilation because its levels are determined by both the number of people breathing out concentrated carbon dioxide and the clean air available to dilute it.

Under a normal load, defined as 26 students, one teacher and one assistant, measured levels of carbon dioxide in the air-conditioned school stayed below 750 parts per million (ppm) and were typically between 500 and 600 ppm.

A reading of 700 ppm is particularly good. It means the people in the room breathe in less than 0.5 percent of air breathed out by others.

But in “naturally ventilated” classrooms, the reading often climbed to 2,500 ppm and sometimes more, within an hour of a class commencing.

At 2,500 parts per million, people in the room are breathing in 5.5 percent of the air breathed out by others. This is also high enough to affect cognition, learning and behaviour, something that begins when carbon dioxide climbs above 1,200 ppm.

Research suggests using ventilation to cut carbon dioxide to 700 ppm can cut the risk of airborne transmission of disease by a factor of two and up to five.

Economic case

In 2023, Australia had 9,629 schools with 4,086,998 students.

ARINA has previously estimated the cost of ensuring all of these schools are mechanically ventilated at A$2 billion per year over five years.

Offsetting that cost would be less sickness. Documents released under freedom of information laws show Victoria spent $360.8 million on casual relief teachers between May 2023 and May 2024, 54 percent more than before COVID in 2019.

The figures for other states are harder to get, but if Victoria (with 26 percent of Australia’s population) is spending $234 million more per year on casual relief teachers than before COVID, it is likely that Australia is spending $900 million per year more.

Add in the teachers in non-government schools (37 percent of Australia’s total), and the potential saving from air conditioning schools exceeds $1 billion per year.

Add in the other non-COVID viruses that would no longer be concentrated and circulated in classrooms and the potential savings grow higher still.

And, in any event, the cost of replacement teachers is a woefully incomplete measure of the cost of illness in schools. Many ill teachers can’t be replaced because replacements aren’t available, making schools cancel lessons and combine classes, costing days, weeks and sometimes months of lost education.

Also, the bacteria and viruses spread by recirculated air infect students as well as teachers, keeping students (and often their parents) at home as well.

This suggests the costs per year of not air conditioning schools exceed $1 billion and may well approach or exceed $2 billion, which is the estimated cost per year over five years of air conditioning every Australian school.

Natural ventilation was never a good idea for classrooms: it was cheap at the time, but not cheap at all when the costs are considered. Those costs happen to extend beyond disease to thermal comfort, energy use and the ability of students to concentrate.

It’s time we gave students and teachers the kind of protections we demand for ourselves in our offices, our shopping centres and often our homes. It would soon pay for itself.

Author details

Geoff Hanmer is Adjunct Professor of Architecture at the University of Technology Sydney and Managing Director of ARINA, an architectural consultancy. He is an Architect and a writer on construction history. He is a member of the executive of the Industry Training and Transformation Centre for Advanced Building Systems against Airborne Infection Transmission (known as Thrive) which receives funding from the Australian Research Council, QUT, the University of Melbourne and industry partners in North America, Europe, Asia and Australia. He is a director of the health expert body OzSAGE.


See Croakey’s archive of articles on the Australian Centre for Disease Control

 

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